Individual
MARY A MUMMAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
10139 E GRANDVIEW RD, TRAVERSE CITY, MI 49684-5429
(989) 293-4927
Mailing address
10139 E GRANDVIEW RD, TRAVERSE CITY, MI 49684-5429
(989) 293-4927
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401010130
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1477745370
—
MT
Enumeration date
05/07/2009
Last updated
10/02/2025
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